Provider Demographics
NPI:1699660761
Name:BATISTA REQUEJO, YINDRA
Entity type:Individual
Prefix:
First Name:YINDRA
Middle Name:
Last Name:BATISTA REQUEJO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4473 MCINTOSH PARK DR APT 812
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6507
Mailing Address - Country:US
Mailing Address - Phone:941-321-5553
Mailing Address - Fax:
Practice Address - Street 1:4473 MCINTOSH PARK DR APT 812
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6507
Practice Address - Country:US
Practice Address - Phone:941-321-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25-430441106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician